<%= form_for([@member_address.profile, @member_address], url: form_url) do |f| %>

	<!-- PHC-Notifi Render Validation -->
	<%= render 'phcnotifi/validations', :object => @member_address %>

	<div class="form-group field_with_errors">
		<label><%= f.label :mcaddressl1, "Address Line1" %></label>
		<%= f.text_field :mcaddressl1, class: "form-control", placeholder: "Address Line 1 - Street Address" %>
	</div>

	<div class="form-group field_with_errors">
		<label><%= f.label :mcaddressl2, "Address Line2" %></label>
		<%= f.text_field :mcaddressl2, class: "form-control", placeholder: "Address Line 2 - Box - Suite - Floor" %>
	</div>

	<div class="form-group field_with_errors">
		<label><%= f.label :mccity, "City" %></label>
		<%= f.text_field :mccity, class: "form-control", placeholder: "City" %>
	</div>

	<div class="form-group field_with_errors">
		<label><%= f.label :mcprovince, "Province/State" %></label>
		<%= f.text_field :mcprovince, class: "form-control", placeholder: "Province/State" %>
	</div>

	<div class="form-group field_with_errors">
		<label><%= f.label :mccountry, "Country" %></label>
		<%= country_select("member_address", "mccountry", { priority_countries: ["CA", "GB", "FR", "US"], selected: "CA" }, { class: 'form-control', data: { attribute: "value" } }) %>
	</div>

	<div class="form-group field_with_errors">
		<label><%= f.label :mcpostalcode, "PostalCode" %></label>
		<%= f.text_field :mcpostalcode, class: "form-control", placeholder: "PostalCode" %>
	</div>

	<div class="form-group">
		<label><%= f.label :mctype, "Address Type" %></label>
		<%= f.select :mctype, [['Billing Address','Billing'],['Street Address','Street'],['Mailing Address','Mailing'],['Home Address','Home'],['Business Address','Business']], {}, class: "form-control" %>
	</div>

	<div class="actions">
		<%= f.submit class: "btn btn-primary" %>
	</div>

<% end %>
